The evolving health care system continues to place barriers and burdens on physicians such that there appears to be a slowly decreasing number of clinical investigators;thereby creating a potential crisis in patient oriented research, this crisis will have multiple impacts on society and the health care system. One answer to this crisis is to support young, active and successful clinical investigators in order to overcome some of the major barriers to patient-oriented research: time, resources, and mentoring. Dr. Mack T. Ruffin represents one of these successful physicians. This application is in response to the Mid-Career Investigator Award in Patient-Oriented Research (PA-98-053) and is a revised request for additional five years of support. The areas of activity of this project are Dr Ruffin's research plan focused on cancer prevention in cervical and colorectal cancer along with his plan for mentoring beginning clinical investigators. Dr. Ruffin will split the 50% effort supported by this award equally on mentoring junior investigators and new research studies. Dr. Ruffin has defined a mentoring program to recruit new junior investigators interested in cancer prevention along with continuing to nurture his existing proteges, Drs. Nease, Zick, Marerro, Patel, and Ferketich. Each protege is in a critical phase of their career development requiring continued support of Dr. Ruffin. The research supported by the continuation of the K24 is focused on cervical cancer prevention. 1) HPV Infection and Diet: To determine if a carotenoid-rich diet high in fruits and vegetables will significantly reduce the incidence of HPV infection among sexually active women. 2) Methylation, HPV, and Cervical Lesion: To estimate the diagnostic value of specific methylation pattern in the LCR/E6 region of HPV 16 genome in a prospective epidemiologic study. Dr. Ruffin has developed a five-year plan to enhance his skills in leading and managing a multidisciplinary research team. This plan includes his participation in the Leadership Development Program offered through a partnership with the University of Michigan Business School, School of Public Health, and Medical School. The goal of the Program is to enhance the leadership capabilities of current and future institution leaders. Dr. Ruffin has established a critical mass of investigators focused on cancer prevention. They have substantial momentum developed toward establishing a self-sustaining research group. However, the group is in a critical phase of development. The continued support of Dr. Ruffin with an additional five years of support will be vital to reaching the goal.